Crohns Disease at a Glance

Ever thought you just don't understand? Well that's how I feel a lot, so why not present the information in a way that is both helpful and easy to understand! That is my goal, to take complicated hard to understand topics and make them easier for you to understand.

Ally's Law states that it is illegal to refuse the use of the bathroom to anyone with any form of IBD. This law came about when a 14 year old girl, Ally Bain, was refused the use of the bathroom and experienced an embarrassing accident while in an Old Navy. Soon after the accident, Ally and her mother contacted Illinois State representative in an attempt to create a law aimed at protecting those with IBD. The bill passed unanimously in the House of Representatives and Senate and Ally's law was born!The law is also known as The Restroom Access Act and it "requires businesses to make employee bathrooms accessible to those with IBD, chronic medical conditions, and pregnancy..." In a state where the law has been passed, if you are still denied access to the restroom then you can call the police and file a complaint and they will be charged with a misdemeanor.The law has been passed in Minnesota, Texas, Kentucky, Tennessee, Colorado, Ohio, Michigan, Washington, Oregon, Wisconsin, and Connecticut and is pending in several others. Similarly, The Foundation for Clinical Research in IBD has created a medical alert card that states:“The holder of this card has Crohn’s disease or ulcerative colitis. Colitis is painful and requires immediate access to a toilet facility. This patient cannot physically 'hold it.' Please make your restroom available.”The passing of Ally's law and the creation of the medical alert card has made accessing the bathroom easier for those suffering from IBD, but we still face many challenges in cities that haven't passed the law and those that do not offer adequate bathroom. But hopefully, in the coming years legislation will continue to pass in favor of those with IBD and the bathroom's will become friendlier to those in need!

When traditional therapies do not work in treating Crohns or Colitis, doctors may try Enteral Nutrition as an alternative therapy. Exclusive Enteral nutrition (EEN) consists of the cessation of a normal diet and instead the administration of a liquid diet aimed at helping the gut heal. EEN can help those with active Crohns by providing bowel rest that leads to nutritional improvements and mucosal healing. The Enteral nutrition is typically administered for 6-8 weeks, but the time period can be altered based on the needs of the patient. In a study done in children recently diagnosed with Crohns Disease, enteral nutrition induced remission is 80% of the children. Although certain formulas have been made more palatable and some people are able to drink enteral formulas, it is still often administered through a feeding tube. With a nasogastric feeding tube, a tube is fed through the nose and into the stomach. Once inserted, the formula is pumped into the stomach to provide nutrition for the patient. In certain circumstances an NG feeding tube isn't possible and a jejunostomy feeding tube may be surgically implanted into the patients stomach. Both methods of enteral nutrition have pros and cons and these must be considered when picking which option to use.When being used for adults with Crohns Disease, the results of enteral nutrition have been inconclusive, but when other methods fail, patients may not have many other options to try. If nothing more, using enteral nutrition may provide the patient with symptomatic relief and more energy. Like in any medical situation, many factors must be considered and a patient must consult their doctor in order to make the best decision for their health. Because the patient must refrain from eating during the duration on the treatment, you must first decide if you will be able to stop eating for a period of time, but if you can refrain from eating during enteral nutrition then EEN may be a viable option for your treatment for Crohns Disease!

What is it?A PICC line is a peripherally inserted central catheter used for various medical purposes. It consists of a long thin tube being inserted into your upper inside portion of your arm. You can then deliver fluids and medicines through this port as well as draw blood. The tube terminates in a large vessel near your heart and at the other end of the tube (the portion coming out of the arm) there is either one or two lumens. A PICC line can be left in for weeks or months depending on how your body reacts to the PICC.

My current PICC line.

What is it used for?A PICC line is used to administer intravenous medicines and other elements that may not be compatible with a normal peripheral IV. This includes things such at TPN, chemotherapy, prolonged IV antibiotics and other IV medicines. Whenever prolonged and frequent IV access is required, a doctor may suggest having a PICC line inserted.

How is it inserted?A PICC line is placed as an outpatient procedure by either a radiologist or a PICC team. First the PICC team will use an ultrasound to find the vein they want to access. Once they have picked the vein, they will swab the area with surgical antiseptic (don't know what this is actually called) and then numb the area. The numbing medicine stings badly for about 30 seconds, but after they are done numbing you shouldn't feel much of anything. They then insert a needle into the vein and use a cannula to thread the tubing into the arm till the tubing reaches the endpoint. Next they remove the needle and cannula and secure the PICC line in place. Overall it is a fairly painless procedure if done correctly and all goes smoothy.

PICC line catheter before being inserted in arm.

Everyday PICC CareYou can live a relatively normal life with your PICC line. You must flush the PICC every twelve hours as well as have the dressing changed at least once a week. But as far physical activities, there are not many limitations, you are free to live your life as before, as long as you are sure to cover your PICC before getting in the shower!

1 in 5 Americans will be diagnosed with some form of IBS (Irritable Bowl Syndrome) at some point in their life

The name Crohns Disease came from Dr. Burrill B. Crohn who first described the disease in 1932

80% of Crohns patients will have to have surgery at least once

There are not many statistic on Crohns disease due to it's uniqueness. No two cases are exactly alike, and doctors have a hard time quantifying that type of data, but the statics I did pull came from various sources around the internet.For further information check out these sources:

Crohns Disease is an autoimmune disease and is in the same family as MS (multiple sclerosis), RA (rheumatoid arthritis), and Plaque psoriasis. In an autoimmune disease the patient’s body attacks itself. With RA the patients body attacks it’s own joints, but the Crohns Disease, the body attacks any part of the digestive tract. Although the cause of Crohns disease is unknown, scientists believe that their is both genetic and environmental factors. Your digestive track starts at your mouth and ends at your butt, and symptoms can present at any point in between. With Crohns Disease, a patient commonly experience:

Nausea

Vomitting

Diarrhea

Weight Loss

Fevers

Pain

Ulcers

Fissures

Fistulas

Although less common, Crohns can cause mouth ulcers, esophageal ulcers, anal abscesses, skin tags and many others.Many Crohns Patients experience debilitating symptoms that can interfere with their life. Patients who experience diarrhea may find that their bottom becomes raw and irritated, which in and of itself can cause a lot of discomfort. Medication used to treat Crohns often causes it's own side-effects, it is often hard to know if symptoms are caused by the illness or the medication. Symptoms most commonly develop in the end of the small intestines and the colon, but symptoms can also present in the stomach, esophagus and anal area. In many cases, doctors treat Crohns Disease using immunosuppressant medications and/or steroids. Crohns can be classified as mild/moderate, moderate/severe, or severe. Patients who have mild cases, often can control their symptoms using medication and diet. However, patients with moderate/severe Crohns may need to go on biologic medication that alters their immune system such as Humira. These medication may or may not put these cases into remission. Although there is no known cure for Crohns, with the proper medication, many patients can experience periods of remission.